What are the Phases of Alcohol Withdrawal?

Alcohol withdrawal is, initially, a very uncomfortable experience for people working to get sober from alcohol use disorder. Determining how severe an individual’s alcohol withdrawal symptoms might be will depend on a few factors, including:

  • Age
  • Weight
  • Length of alcohol use disorder
  • Severity of drinking
  • Type of alcohol preferred
  • Underlying mental health conditions

When an individual enters treatment for alcohol use disorder, the first thing they will experience is the detox process. There are four phases of alcohol withdrawal, including aftercare. Knowing these four phases can help you better understand what to expect, and how treatment can help throughout each phase.

Phase 1 of Alcohol Withdrawal

Alcohol withdrawal begins within 6-12 hours after the last drink. This negative feeling after a night of drinking is popularly known as a hangover. Many people are familiar with this first phase, and usually, a good night’s sleep can help shake it off. However, for individuals suffering from alcohol use disorder, their hangovers are actually Phase 1 withdrawal symptoms manifesting. The initial first phase of alcohol withdrawal symptoms include:

  • Anxiety
  • Abdominal pain
  • Headaches
  • Insomnia
  • Nausea and vomiting
  • Shaking

How Treatment Helps through Phase 1 of Alcohol Withdrawal

In medically assisted detox, you will be able to experience minimal-to-none of the above symptoms. This is due to onsite medical staff specially trained in the area of addiction administering medications such as:

  • Naltrexone to help control intense alcohol cravings, which peak during the first 90 days of treatment
  • Acamprosate to help the body and central nervous system to readjust and restore balance, which helps keep the uncomfortable withdrawal symptoms to a minimum
  • Anxiety medications to assist with anxiety attacks
  • Nausea medication to keep vomiting at bay
  • Sleep aids and headache medication to help the individual feel more comfortable

Phase 2 of Alcohol Withdrawal

After the first phase of alcohol withdrawal, more withdrawal symptoms present themselves within the first 24-48 hours after the last drink. These include:

  • Confusion
  • Hand tremors
  • Heart palpitations
  • High blood pressure
  • Increased body temperature
  • Seizures

How Treatment Helps through Phase 2 of Alcohol Withdrawal

During phase 2 of alcohol withdrawal, which is up to 72 hours after the last drink, withdrawal symptoms are at their peak. This is the phase where relapse is most likely, making it extremely important to go through alcohol detox under medical supervision. In order to help our clients through this phase successfully, treatment can offer:

  • Around the clock medical care
  • Addiction counselors and therapists to offer support and guidance
  • Disulfiram, a medication that works as a drinking deterrent. It creates severe nausea and vomiting when alcohol is consumed, even in small doses, which acts as an extra buffer to prevent relapse
  • Naltrexone will still be administered during this phase, and this medication works to help control intense alcohol cravings
  • Medication to assist with seizures, high blood pressure, and fever, in addition to ongoing help for sleep and nausea

Phase 3 of Alcohol Withdrawal

Phase 3 of alcohol withdrawal is the most difficult phase to get through for individuals with severe alcohol use disorder. Symptoms presented in this phase can last up to 4 days, and they include:

  • Hallucinations
  • Seizures
  • Delirium tremens

How Treatment Helps through Phase 3 of Alcohol Withdrawal

Delirium tremens is a deadly alcohol withdrawal symptom. It is caused by sudden and severe changes in the nervous system and can lead to respiratory depression, deadly seizures, and dangerous hallucinations. Treatment helps by:

  • Providing around-the-clock medical care to stabilize delirium tremens
  • Medication for symptoms associated with delirium tremens, such as hallucinations and seizures

Ongoing Aftercare for Alcohol Withdrawal

Becoming sober from alcohol involves much more than a 30, 60, or 90-day treatment stay. It involves ongoing aftercare. Reasons for this include:

  • Support. Going through alcohol recovery alone is extremely difficult and impossible. That is why having the support of family, friends, and like-minded sober people is extremely important. However, not everyone has this type of support, but it can easily be found in various sober support group.
  • Ongoing acute post alcohol withdrawal symptoms. Many individuals who have suffered from severe addiction may experience acute alcohol withdrawal symptoms for months or years.
  • Dealing with cravings. Learning your body and how it responds to cravings is essential for a successful recovery.
  • Learning how to navigate triggers. What will happen the next time you are at a party or are offered alcohol? A huge factor in staying sober involves learning how to navigate these triggers successfully and feel happy with your choices.
  • Rebuild relationships with loved ones. One of the many casualties of addiction is broken relationships. Addiction can take away trust, love, and much more from the people we care about. That is why continuing with ongoing therapy and effort to rebuild relationships with loved ones is important during recovery.
  • Finding new ways to cope with stress. After a long day at work with nagging from your boss, an argument with your spouse, or having too many things happening at once can be stressful, and a way you used to relax was by drinking alcohol. How will you learn to deal with stress now? Finding new ways to cope with life’s stressors is important, and can be as simple as exercise, watching a funny movie, or ordering your favorite takeout.

Some ways to continue with aftercare after leaving treatment include:

  • Living in a sober living facility
  • Creating boundaries with family members
  • Regularly attending AA meetings
  • Going back to treatment if a relapse happens
  • Keeping up with medications to help curb cravings

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